title: An ecological analysis of sociodemographic factors associated with the incidence of salmonellosis, shigellosis, and E. coli O157:H7 infections in US counties.
abstract: Identifying county-level sociodemographic and economic factors associated with the incidence of enteric disease may provide new insights concerning the dynamics of community transmission of these diseases as well as opportunities for prevention. We used data from the National Notifiable Diseases Surveillance System, the U.S. Census Bureau, and the Health Resources and Services Administration to conduct an ecological analysis of 26 sociodemographic and economic factors associated with the incidence of salmonellosis, shigellosis, and E. coli O157:H7 infections in US counties for the period 1993 to 2002. Our study indicates that race, ethnicity, place of residence, age, educational attainment, and poverty may affect the risk of acquiring one of these enteric bacterial diseases. The lack of specificity of information regarding salmonellae and shigellae serotypes may have led to less specific associations between community-level determinants and reported incidence of those diseases. Future ecological analyses should use serotype-specific data on incidence, which may be available from laboratory-based surveillance systems.
authors.affiliation: Division of Integrated Surveillance Systems and Service, National Center for Public Health Informatics, Coordinating Center for Health Information and Service, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. mchang@cdc.gov
authors.forename: M
authors.initials: M
authors.lastname: Chang
authors.forename: S L
authors.initials: SL
authors.lastname: Groseclose
authors.forename: A A
authors.initials: AA
authors.lastname: Zaidi
authors.forename: C R
authors.initials: CR
authors.lastname: Braden
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004405:Dysentery, Bacillary / Q000191:economics / Q000453:epidemiology*; D017753:Ecosystem; D004927:Escherichia coli Infections / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology; D019453:Escherichia coli O157; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012480:Salmonella Infections / Q000191:economics / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult